Nandkishore Agrawal

Isolated pericardial and intracardiac hydatidosis: presentation as congestive cardiac failure and fatal pulmonary embolism

Localization of hydatid cysts in the heart is a rare phenomenon, with an incidence of 0.5-2%. In almost half these cases, the heart is the sole organ to be involved. We report a case of massive pericardial hydatidosis in a female patient who presented with features of congestive cardiac failure. Cysts in the endocardium of right side of the heart resulted in fatal pulmonary embolism.

Aortic Pseudo‐Aneurysm: Cause of Life‐Threatening Hemoptysis in a 13‐Month‐Old Child

Abstract  Aortic aneurysms and pseudo‐aneurysms are a rare occurrence in the pediatric age group. True aneurysms are usually related to infection or to inherited disorders while pseudo‐aneurysms occur following trauma or infection. We present a case of a pseudo‐aneurysm of the descending thoracic aorta in a 13‐month‐old child, who presented with life‐threatening massive hemoptysis. Though no clear‐cut etiologic factor was identified on clinical examination and investigations, presence of neutrophilic infiltration in the wall suggested an infective nature.

Rhabdomyoma of the Right Atrium: Report of a Case

Abstract  Rhabdomyomas are the most common primary cardiac tumors in childhood, and are considered to be congenital lesions. They are uncommon in adolescents and adults due to their tendency for spontaneous regression. Majority of them are located in the ventricular chambers, and are also associated with tuberous sclerosis. The indications for surgery include hemodynamic compromise and intractable arrhythmias. We describe a right atrial rhabdomyoma in a previously healthy 16‐year‐old girl who presented with palpitation and dizziness of recent onset. Postoperative evaluation had not revealed stigmata of tuberous sclerosis.

Femoral Artery Pseudoaneurysm Caused by External Fixator

FEMORAL ARTERY PSEUDOANEURYSM CAUSED BY EXTERNAL FIXATOR We recently treated a case of superficial femoral artery pseudoaneurysm resulting from external fixator pins. The patient was a 35-year-old general surgeon who sustained a grade-2 open fracture of the right femur. There was minimal loss of tissue on the anterior aspect of the thigh and no distal neurovascular deficit. The femur was stabilized with Hoffmann transfixation pins and a doublesquare frame. After 3 months, the patient noticed a pulsatile swelling on the anteromedial aspect of the right thigh, close to the external fixator pin. Angiography revealed a moderate-sized pseudoaneurysm of the right femoral artery arising from the anteromedial aspect, which was excised with end-to-end repair of the femoral artery.

Left Atrial Myxoma: Experience with Different Approaches Including Superior Transseptal Approach

Forty-nine patients underwent surgical excision of left atrial myxomas during a period of 14 years (1982 to 1995). There were 25 male and 24 female patients. In all cases, the diagnosis was based on clinical examination and echocardiography; cardiac catheterization was performed in 9 patients. We considered the diagnosis of myxoma as an indication for early surgery. The myxoma was excised using various approaches: right atrial transseptal incision (38), biatrial incision (9) and superior transseptal approach (2). The latter approach has not been utilized for excision of myxoma before. One patient died in the early postoperative period. New cardiac arrhythmias were observed in 4 patients while the others had an uneventful recovery. Forty-two patients returned for follow-up over a period ranging from 0.4 to 13.6 years. They were evaluated clinically and echocardiographically. All have recovered well and we conclude that left atrial myxoma can be treated with low mortality and morbidity.